Vitamin D Binding Protein: A Potential Factor in Geriatric COVID-19 Acute Lung Injury.

Background: Previous research indicated that vitamin D binding protein (VDBP) is an independent multifunctional protein that plays a vital role in acute inflammatory and tissue damage. However, its role in acute lung injury (ALI) due to coronavirus disease 2019 (COVID-19) is unclear, and studies are lacking. This study intends to investigate the difference in serum VDBP levels in COVID-19 patients with ALI or without ALI and further explore the role of VDBP in the inflammatory response of ALI through cellular models. Methods: The serum was collected from COVID-19 patients, and the concentration of serum VDBP was detected. Construct a VDBP gene-silencing plasmid and transfect it into human alveolar epithelial A549 cells. After 72 hours of lipopolysaccharide (LPS) intervention, The inflammatory factors interleukin-1ß (IL-1ß) and tumor necrosis factor-α (TNF-α) were detected, and cell counting kit-8 (CCK-8) assay was used to detect cell viability. Flow cytometry was used to detect cell apoptosis. Results: The serum concentration of VDBP was significantly higher in COVID-19 with ALI (P < 0.05). Correlation analysis indicated serum VDBP positively correlated with leukocyte (r=0.329, P = 0.002), c-reaction protein (r = 0.470, P < 0.001), serum amyloid A (r = 0.900, P < 0.001), procalcitonin (r = 0.670, P < 0.001), and interleukin 6 (r = 0.452, P < 0.001). Simultaneously, the logistic regression analysis showed that increased serum VDBP was an independent risk factor for ALI in COVID-19 patients (OR 1.003 95% CI 1.001-1.006, P = 0.002). In human alveolar epithelial A549 cells, after LPS intervention, the inflammatory factor IL-1ß and TNF-A significantly reduced in the VDBP gene silencing group compared to the negative control (NC) group (P < 0.05). The cell viability of the VDBP gene silencing group was significantly increased compared to the NC group, and the cell apoptosis rate was significantly reduced (P < 0.05). Conclusion: In COVID-19 patients, acute lung injury may lead to increased serum concentration of VDBP. VDBP plays a vital role in promoting inflammatory response and apoptosis of bronchial epithelial cells.

The relationship between comprehensive geriatric assessment on the pneumonia prognosis of older adults: a cross-sectional study.

BACKGROUND: The mortality of pneumonia in older adults surpasses that of other populations, especially with the prevalence of coronavirus disease 2019 (COVID-19). Under the influence of multiple factors, a series of geriatric syndromes brought on by age is one of the main reasons for the poor prognosis of pneumonia. This study attempts to analyze the impact of geriatric syndrome on the prognosis of pneumonia. METHODS: This is a prospective cross-sectional study. Patients over 65 years old with COVID-19 and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-negative community-acquired pneumonia (SN-CAP) were included in the research. General characteristics, laboratory tests, length of stay (LOS), and comprehensive geriatric assessment (CGA) were collected. Multivariate regression analysis to determine the independent predictors of the severity, mortality, and LOS of COVID-19. At the same time, the enrolled subjects were divided into three categories by clustering analysis of 10 CGA indicators, and their clinical characteristics and prognoses were analyzed. RESULTS: A total of 792 subjects were included in the study, including 204 subjects of SN-CAP (25.8%) and 588 subjects (74.2%) of COVID-19. There was no significant difference between non-severe COVID-19 and SN-CAP regarding mortality, LOS, and CGA (P > 0.05), while severe COVID-19 is significantly higher than both (P < 0.05). The Barthel Index used to assess the activities of daily living was an independent risk factor for the severity and mortality of COVID-19 and linearly correlated with the LOS (P < 0.05). The cluster analysis based on the CGA indicators divided the geriatric pneumonia patients into three groups: Cluster 1 (n = 276), named low ability group, with the worst CGA, laboratory tests, severity, mortality, and LOS; Cluster 3 (n = 228), called high ability group with the best above indicators; Cluster 2 (n = 288), named medium ability group, falls between the two. CONCLUSION: The Barthel Index indicates that decreased activities of daily living are an independent risk factor for the severity, mortality, and LOS of geriatric COVID-19. Geriatric syndrome can help judge the prognosis of pneumonia in older adults.

Predicting air pollutant emissions of the foundry industry: Based on the electricity big data.

Industrial enterprises are one of the largest sources of air pollution. However, the existing means of monitoring air pollutant emissions are narrow in coverage, high in cost, and low in accuracy. To bridge these gaps, this study explored a predicting model for air pollutant emissions from foundry industries based on high-accuracy electricity consumption data and continuous emission monitoring system (CEMS). The model has then been applied to the calculation of air pollutant emissions from foundries without CEMS and the optimization of air pollutant emission temporal allocation factors. The results reveal that electricity consumption and PM emissions during the 2022 Beijing Winter Olympics have the same ascending and descending relationship. Furthermore, a cubic polynomial model between electricity consumption and flue gas flow is established based on the whole year data of 2021 (R2 = 0.85). The relative errors between the PM emissions calculated by the model and the emission factor method are small (-17.09-24.12 %), and the results from the two methods revealed a strong correlation (r = 0.93, p < 0.01). In addition, the monthly PM emissions from foundries are mainly concentrated in spring and winter, and the daily emissions on weekends are significantly lower than those on workdays. These results can be useful for environmental regulation and optimization of air pollutant emission inventories of foundry industry.

Effects of Tai Chi on patients with moderate to severe COPD in stable phase.

This study was designed to investigate the effects of Tai Chi training on moderate to severe Chronic obstructive pulmonary disease (COPD) in the stable phase. This was a 2-arm randomized clinical trial. A total of 226 COPD patients with moderate to severe in the stable phase were allocated to either the control group or the observation group. The observation of the frequency of acute exacerbation for both groups lasted for at least 52 weeks follow-up. Changes in lung function and symptom scores of health-related quality of life (St George's Respiratory Questionnaire score) were also compared between the 2 groups. The accompanying anxiety and depressive symptoms of the patients were evaluated using the Self-Rating Depression Scale and Self-Rating Anxiety Scale prior to the procedure and 52 weeks later. Patients with moderate to severe COPD in China were divided into the Tai Chi group (n = 116) or control group (n = 110). After excluding 10 patients who fell off, 108 patients were enrolled in each group. Evidently, the matched group had higher exacerbation rate than the Tai Chi group (P < .05). Both groups showed no significant improvement in lung function (P > .05) but showed significant improvement in morbidity of acute exacerbation and quality of life (P < .05) compared with their former performance. Compared with regular therapy, Tai Chi also improved health-related quality of life (P < .05). The Self-Rating Anxiety Scale and Self-Rating Depression Scale scores of the 2 groups of patients after treatment and 52-week after treatment showed a notable decrease (P < .05). Overall, Tai Chi treatment was well tolerated. For moderate to severe COPD patients, regular treatment with Tai Chi can not only improve their health-related quality of life but also reduce the exacerbation rate compared with regular treatment alone. Tai Chi is recommended for COPD rehabilitation.

Associations between air pollutants and hospital admissions for chronic obstructive pulmonary disease in Jinan: potential benefits from air quality improvements.

Evidence between air pollution and chronic obstructive pulmonary disease (COPD) is inconsistent and limited in China. In this study, we aim to examine the associations between air pollutants and hospital admissions for COPD, hoping to provide practical advice for prevention and control of COPD. Hospital admissions for COPD were collected from a Grade-A tertiary hospital in Jinan from 2014 to 2020. A generalized additive model (GAM) was used to examine the associations between air pollutants and hospital admissions for COPD. Stratified analysis was also conducted for gender, age (20-74 and ≥75 years), and season (warm and cold). The avoidable number of COPD hospital admissions was calculated when air pollutants were controlled under national and WHO standards. Over the study period, a total of 4,012 hospital admissions for COPD were recorded. The daily hospital admissions of COPD increased by 2.36% (95%CI: 0.13-4.65%) and 2.39% (95%CI: 0.19-4.65%) for per 10 µg/m3 increase of NO2 and SO2 concentrations at lag2, respectively. There was no statistically significant difference in health effects caused by increased concentrations of PM2.5, PM10, CO, and O3. The health effects of increased SO2 concentration were stronger in women, the ≥75 years old people and the cold season. About 2 (95%CI: 0-3), 64 (95%CI: 4-132) and 86 (95%CI: 6-177) COPD admissions would be avoided when the SO2 concentration was controlled below the NAAQS-II (150 µg/m3), NAAQS-I (50 µg/m3), and WHO's AQG2021 standard (40 µg/m3), respectively. These findings suggest that short-term exposure to NO2 and SO2 was associated with increased risks of daily COPD admissions, especially for females and the elderly. The control of SO2 and NO2 under the national and WHO standards could avoid more COPD admissions and obtain greater health benefits.

Impact of Cross-Linked Chitosan Sublayer Structure on the Performance of TFC FO PAN Nanofiber Membranes.

Polyacrylonitrile (PAN) is a popular material in membrane field because of its excellent mechanical property, thermal stability, and chemical resistance. Unfortunately, PAN nanofibers produced by electrospinning are not suitable for interfacial polymerization process directly due to its hydrophobicity and large average pore size. In this work, the cross-linked chitosan (CS) solution was coated on the nanofiber surface to fabricate a sublayer, based on which thin-film composite (TFC) membranes were prepared using m-phenylenediamine and 1,3,5-trimesoyl chloride as the monomers. The impact of the different sublayers on the performances of TFC PAN nanofiber membranes for forward osmosis (FO) was studied by varying cross-linked CS concentrations. The results indicated that the increased CS concentration not only led to the relatively denser polyamide layer, but also changed its morphology. In the reverse osmosis process, NaCl rejection increased from 46.5 to 83.5%. Salt flux from feed solution to draw solution decreased from 25.8 to 8.9 g·m-2·h-1 (0.1 M NaCl solution as feed, 2 M glucose solution as draw solution, FO mode). This study found that the sublayer had noteworthy impact on the separation layer and helped us to pave the way to design high-performance FO membranes.

Increased serum VDBP as a risk predictor for steroid resistance in asthma patients.

BACKGROUND: Asthmatic symptoms usually can be controlled with corticosteroids, but partly asthmatic patients do not respond to corticosteroids, steroid resistance (SR) play a significant role in the poorly responding. However, no approach can accurately predict steroid responsiveness in asthma patients, so prediction of SR with noninvasive means has become a critical issue. OBJECTIVE: The aim of this study was to evaluate the difference in serum proteomes between steroid-sensitive asthma (SSA) and steroid-resistant asthma (SRA) patients and identify potential biomarkers for the prediction of SR in asthma patients. METHODS: We performed a proteomic approach of fluorescence-based difference gel electrophoresis (DIGE) and mass spectrometry to identify biomarkers in the serum obtained from SRA and SSA patients (n = 6 in each group). The interesting biomarker was further studied using western blot and enzyme-linked immunosorbent assays (ELISA). RESULTS: Seven differentially expressed proteins between SSA and SRA group were identified. Among them, vitamin D-binding protein (VDBP) attracted our further attention as the greatest changed protein. Serum VDBP was significantly up-regulated in SRA group compared with SSA group, and the differential expression was confirmed with western blot analysis. The ELISA data showed the serum level of VDBP was significantly higher in SRA group than that in SSA and control group (496.50 ± 204.62 vs. 279.73 ± 163.65, 241.93 ± 98.58 µg/ml, respectively, p < 0.01). Correlation analysis indicated serum VDBP was positively correlated with neutrophils% and monocytes% (p < 0.05), but inversely correlate with serum 25OHD (p < 0.05). Regression analysis showed increased serum VDBP was a risk predictor of SRA, and serum 25OHD was an independent influential factor of serum VDBP. Using the receiver operating characteristic curve, we determined the area under the curve (AUC) of VDBP was 0.792, and the optimal serum cutoff value of VDBP was 355.8 µg/ml, which can discriminate SRA from asthma patients with 65.2% sensitivity and 83.7% specificity. CONCLUSIONS: This study provides a novel overview of the difference in serum proteomes of SSA and SRA. We suppose serum VDBP may serve as a useful biomarker for predicting SR in asthma patients, and may participate in the pathogenesis of SRA.

[The effect of inhaled glucocorticoid therapy on serum proteomics of asthmatic patients].

OBJECTIVE: To screen the biomarkers which may play important roles in the pathogenesis and therapy of asthma by using serum comparative proteomics. METHODS: From June 2011 to September 2012, 30 chronic persistent asthmatic patients (asthma group) and 30 healthy controls (control group) were selected for study in our hospital. All the asthmatic patients were given 8 week-treatment with inhaled glucocorticoids (ICS). Then comparative proteomics were employed to identify differential proteins in serum samples from the control group, the asthma pre-treatment group and the asthma post-treatment group. The differential proteins which had significant differences before and after ICS therapy were selected for Western blot analysis and ELISA detection. Besides, the correlation between the differential proteins and IgE, eosinophils (EOS), neutrophil percentage(NEUT%), and FEV1% were analyzed. RESULTS: Eleven differential proteins were identified. Among them, heat shock protein 70 (HSP70), eosinophil chemotactic protein (Eotaxin) and vitamin D binding protein (VDBP) had significant differences in protein abundance before and after treatment. The differential expression of the 3 proteins in each group was confirmed by Western blot. ELISA data showed that the serum levels of HSP70 and Eotaxin were significantly higher in the asthma pre-treatment group [(439 ± 103)ng/L, (183 ± 79)ng/L] than those in the control group [(209 ± 58)ng/L, (91 ± 46)ng/L] (t = 5.281, 4.972, all P < 0.01), but significantly lower in the asthma post-treatment group[(247 ± 96) ng/L, (105 ± 58)ng/L] than those in the pre-treatment group (t = 4.157, 3.892, all P < 0.01). However, the serum level of VDBP was significantly lower in the asthmatics pre-treatment group [(318 ± 115)mg/L] than that in the control group [(541 ± 98)mg/L] (t = 3.878, P < 0.01), but significantly higher in the asthma post-treatment group[(479 ± 132)mg/L] than that in the pre-treatment group(t = 3.572, P < 0.01). The correlation analysis showed that HSP70 was correlated positively with IgE and NEUT%, but negatively with FEV1% (r = 0.568, 0.613, -0.516, all P < 0.01). Eotaxin was correlated positively with IgE and EOS, but negatively with FEV1% (r = 0.752, 0.826, -0.618, all P < 0.01). VDBP was correlated negatively with NEUT%, but positively with FEV1% (r = -0.537, 0.426, all P < 0.05). CONCLUSIONS: HSP70, Eotaxin, and VDBP may participate in the pathogenesis of asthma, and may become the potential targets for ICS therapy.

Association of ADAM33 gene polymorphisms with asthma in a Chinese population.

BACKGROUND AND AIM: Asthma is a very common disease involving genetic and environmental factors. A disintegrin and metalloproteinase 33 (ADAM33) has been one of the most exciting candidate genes for asthma since its first association with the disease in the white population. Recently, studies on the association of ADAM33 gene polymorphisms with the risk of asthma have been controversial. We therefore focused on testing the hypothesis that either single-nucleotide polymorphisms (SNPs) of the ADAM33 gene may be associated with asthma risk. The aim of this study was to evaluate the potential relationship between polymorphisms of ADAM33 and asthma in a Han population in China. METHODS: A case control study was conducted in a Han population of eastern Chinese population. A total of 329 asthma patients and a control group of 316 healthy volunteers were recruited for this study. Four polymorphic sites (F+1, S2, T2 and V4) were selected for genotyping. Genotypes were determined by the allele-specific polymerase chain reaction with fluorescence melting curves and DNA sequencing method. Data were analysed using the chi-squared test software. RESULTS: Statistically significant differences in the distributions of the S2 site between patients and controls were observed (χ2=7.140, P<0.05). CONCLUSION: These preliminary results suggest an association between ADAM33 polymorphisms S2 C/G and asthma in a Chinese Han population. The SNPs (F+1 C/T, T2 G/A and V4 C/G) of the ADAM33 gene may be the causal variants in asthma disease, but the strength of this evidence is limited by our small sample size.

Effect of glucocorticoid in mice of asthma induced by ovalbumin sensitisation and RSV infection.

OBJECTIVE: To investigate the inflammatory changes and the airway hyper-responsiveness in the asthma mouse model infected by respiratory syncytial virus and elucidate the relationship between the infection and the effect of glucocorticoid. METHODS: 60 BALB/c mice were randomly divided into 6 groups. One of these is the control group; the others are the OVA/sham group, the OVA/sham +Dex group, the PBS/RSV group, the OVA/RSV group and the OVA/RSV+Dex group. The airway resistance was measured using a sealed body plethysmograph. Pathological slides were stained with hematoxylin-eosin, and the peribronchial inflammation was observed microscopically. The concentrations of IL-4, IFN-gamma, TGF-beta1 in lung tissues were detected by ELISA. RESULTS: Compared with the control group, the degree of the airway inflammation and hyperresponsiveness and the concentrations of IL-4/IFN-gamma, TGF-beta1 in all four OVA groups increased significantly. And there was a statistically significant difference between the OVA/sham group and the OVA/sham+Dex group, and between the OVA/RSV group and the OVA/RSV+Dex group respectively. Compared with the OVA/RSV group, there was an obvious aggravation of airway inflammation and hyper-responsiveness in the OVA/RSV+Dex group. CONCLUSIONS: Glucocorticoid significantly reduces airway inflammation and hyper-responsiveness induced by repetitive OVA challenge in the mouse model of asthma. However, the significant decrease in Th1 and increase in Th2 inflammation and aggravation of airway hyper-responsiveness in the mice in OVA/RSV group show that they are not sensitive to glucocorticoid. The effects of infection with RSV on the mouse model of asthma could be the cause of the glucocorticoid resistance during the therapy.

[The relationship between transforming growth factor-beta1, platelet derived growth factor and airway remodeling in eosinophilic bronchitis].

OBJECTIVE: To study the relationship between the expression of transforming growth factor-beta(1) (TGF-beta(1)) and platelet derived growth factor (PDGF) and airway remodeling in eosinophilic bronchitis (EB). METHODS: Bronchial biopsy specimens were obtained from 12 patients with EB (A group), 10 asthmatic patients (B group) and 10 patients (C group) with peripheral lung cancer in early stage. The subepithelial basement membrane (SBM) thickness was measured by light microscopy using HE staining. The expressions of TGF-beta(1) and PDGF in the bronchial mucosa were examined by immunostaining. RESULTS: The SBM of A group [(6.3 +/- 1.4) micro m] was significantly thicker than that of C group [(4.1 +/- 1.2) micro m, P < 0.05], but significantly thinner than that of B group [(8.2 +/- 1.5) micro m]. The numbers of positive cells for TGF-beta(1) and PDGF in A group (59 +/- 9, 47 +/- 7 respectively) and B group (85 +/- 12, 76 +/- 11, respectively) were significantly higher than those in C group (31 +/- 4, 20 +/- 3, respectively), and were positively correlated with SBM thickness (r = 0.76, 0.52, P < 0.05). CONCLUSION: These results suggest that TGF-beta(1) and PDGF expressions in bronchial mucosa may play a role in bronchial subepithelial fibrosis in EB patients.